Archived: Virginia Lodge Care Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This key question was previously rated good. This key question remains good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff shared the vision of providing people with high quality care, and did not want to settle for less than this. Expectations from leaders were clear. They took action where staff did not uphold these standards. Staff pulled together during unexpected absences and times of unexpected incidents in the service to maintain a smooth, person-centred approach to care.

Staff delivered compassionate and dignified care at all times, in line with the ethos of the service. Supervision meetings and observations by leaders ensured these standards were upheld.

Relatives and people told us the service had dealt transparently with concerns and worked with them. We fed back to the provider the need to clarify one area of concern from one relative.

Equality and diversity amongst staff were respected. External professionals had confidence in the leadership of the service.

Policies and procedures had regard to person-centred care principles, equality, diversity, human rights and inclusion. Some were slightly out of date and in need of review.

Leaders genuinely cared about the service they were responsible for and supported staff through on-site and hands-on support when needed.

Leaders were firm in their expectations of care standards, and sympathetic and supportive to staff who experienced challenging workplace or personal situations. Leaders had the experience and knowledge necessary to lead the service.

One staff member said, “I have always found them firm and fair. They have been really supportive and I think they get that back from staff.”

Leaders set an example and addressed poor care when they were made aware of it.

Policies and procedures supported the delivery of a person-centred approach at the service.

Leaders had worked hard to foster an open culture. Where there had been some staff turnover, they communicated clearly with staff to ensure expectations and values were clearly understood by all.

People, relatives and staff we spoke with found the manager and deputy approachable and listened to them. One relative said, “They have always listened and always acted on what we’ve said. I think they are genuinely passionate about the place and the people.”

There was a whistleblowing policy in place and contact information for external partners was shared with staff should they need it.

Staff we spoke with all felt they could raise concerns with leaders. There was a consensus of opinion that leaders dealt openly and fairly with concerns or queries raised.

The provider had policies and systems in place to support people, relatives and staff to speak up if they needed.

Leaders understood the strength in a diverse workforce and were welcoming of different experiences and skills.

Staff worked effectively as a team. Recruitment record keeping was at times lacking in detail exploring the strengths prospective staff could bring through their diversity of experience and skill. The provider recognised this and agreed to review recruitment practices.

Leaders were mindful of the potential disparities in the experience of staff with protected equality characteristics, or those from excluded and marginalised groups. They ensured the culture was inclusive and respectful.

Leaders were clear on how to oversee day-to-day running of the service and to ensure people were safe. They made sure errors and incidents were acted on promptly. Record keeping was well maintained to support this. Supervisions and additional training were implemented when standards were not to the expected standard.

Systems and resources were available to help leaders review practice and make improvements. There was however inconsistency between leaders regarding who led on aspects of auditing and analysis. This meant that opportunities for additional learning and analysis of trends/patterns had been missed.

Relevant notifications had not always been made to external partners, including CQC, in as timely a fashion as possible.

Leaders worked openly with external professionals and agencies, to meet people’s changing needs and to explore improving practice. They shared information when needed. People did benefit from some external visitors but these were limited. Leaders recognised this, and that there had been opportunities missed to have ‘champions’ in place regarding making links with local community groups and organisations.

People we spoke with were comfortable, safe and happy in their home.

The provider had not always engaged in provider forums, meaning they potentially missed out on positive working relationships and networks. The provider recognised the potential improvements partnership working delivered. They had prioritised ensuring people’s immediate needs were safely met but recognised the need to explore partnership and community working.

Leaders were aware of and implemented areas of best practice, for instance in the tools they used to monitor people’s care needs. Their lack of partnership collaboration meant they were not always aware of developments in some areas of best practice.

Leaders were passionate about the service providing good care to people with whom they had built up mutually respectful relationships. The deputy manager brought a range of experience from health and care settings and worked well with other leaders to maintain a good level of day-to-day oversight of the service.

There had been a lack of demonstrable learning and improvement at our last inspection. This had improved significantly during this inspection, with stronger governance and accountability arrangements in place. The registered manager ensured wider safety and other messages were shared appropriately with staff. When incidents occurred in the service and learning needed to be shared, this was done through daily handovers, team meetings and individual and group supervisions.

Care records were well maintained and easy to access. This meant external health and care professionals could access people’s records and contribute to their ongoing support more easily.

Staff we spoke with felt they had the opportunity to develop their careers within a supportive and person-centred environment.